The new priests

Recently I met with a group of senior psychiatric trainees to talk about "Spirituality and Mental Health" which is always a controversial topic - should we ask about faith, should we share our faith, should we care about faith? The pioneer psychoanalyst Carl Gustav Jung once said that "Psychiatrists are the New Priests", meaning that we used to go and confess to a priests, but today we go and do the same with a 'shrink'. But do the new priests want this role?

When people go and see a priest, they are in part looking for some one to talk to, someone to tell them that this has happened to other people too. But they are also looking for absolution of some kind - for forgiveness, for an encounter, for a spiritual intervention. When psychiatrists try to help people, they do so based on the sciences of medicine and psychology and, though the 'human' element may be stronger in psychiatry than other medical disciplines, absolution is not an area that psychiatrists are trained in - nor one they may want to adopt.

Some argue that if you are a Christian, you need to see a Christian Psychiatrist. There has even been a book written on it. Whilst I agree with a lot in the book, there are also some problems with what it says. There are not enough 'Christian Psychiatrists', sometimes you need a psychiatrist and not a priest, and (for many aspects of your care) a psychiatrist who does not share your faith will do just fine. What is needed, however, is a psychiatrist who respects your faith. Moreover, they need to proactively ask about it just as much as they need to ask about your upbringing, your social situation and your aspirations as it is just as core to your mental health.

Psychiatrists, research shows, are less likely to be people of faith than the general population. Many also feel unsure about asking questions about faith, and the emphasis on science in medicine certainly doesn't help. They can be unsure how to deal with come-back questions about their own faith, or whether they will be able to answer detailed queries about how faith and mental health interact. However, most people just want to be listened to and have their core beliefs noted and respected. My own practice is to ask all people, "Do you have a faith that helps you at a time like this?" [more on this here] and see what comes next. Luckily, there is an increasing need to this topic to be taken seriously. Public pressure about person-centred care means people expect to be asked, and legislation such as the planned Single Equalities Act will make asking a requirement.

The new priests have a choice. One option is to see the trends and the Equality agenda as irrelevant to psychiatry and just get on with what can perceived as the 'core' of their work. The other is to find a halfway house with Jung - to be part priest and part shrink, to work together with faith communities and practice [w]holistically. To be quite honest, I don't want the job of priest; but I'm all up for multiple, varied and complementary approaches to increased mental wellbeing.
Rob Waller, 12/09/2008